Florida Medicare Supplement Plans (Medigap)
Florida Medicare Supplements go hand in hand with Medicare to give you more complete coverage for your health care needs. Medicare Supplement plans were created to cover expenses that aren’t covered by Original Medicare. This includes deductibles, copays and coinsurance.
Medicare Supplements are insurance policies sold by private insurance companies. They’re also known as “Medigap” plans. They go along with the four Medicare parts.
Medicare is broken down into four parts, plus Medigap.
- Hospitalization coverage (Part A)
- Medical expenses (Part B)
- “Medicare Advantage” (Part C) is an alternative to Original Medicare.
- Medicare Part D is prescription drug coverage for Original Medicare beneficiaries.
There are 10 Medicare Supplement, or Medigap, plans sold in Florida. They provide additional coverage for deductibles, copays, coinsurance and other medical expenses that Medicare does not pay.
What does Medicare Cover in Florida
Medicare Parts A and B cover many – but by no means all – of your healthcare costs. For example, Part A covers 60 days of hospitalization in a hospital or skilled nursing facility.
However, after that you are responsible for hundreds of dollars per day in coinsurance. Part B only covers 80 percent of your other medical costs, and you must pay the other 20 percent out of your own pocket.
Eligibility for Medigap in Florida
To sign up for a Medicare Supplement plan, you must be at least 65 and enrolled in Medicare Part B. Medicare Supplements are not available to people with Medicare Advantage (Part C) plans.
Unless you are still covered by an employer or union-sponsored health insurance plan, you will pay a late enrollment penalty if you do not enroll in Part B as soon as you are eligible – during a seven-month initial enrollment period (IEP) around your 65th birthday.
You can still sign up after your IEP ends, but a penalty will be added to your premium every month. And the longer you wait, the higher the penalty will be. If you have employer or union coverage, you will avoid the penalty if you enroll promptly after that coverage ends.
Florida Medicare Benefits for the Disabled Under 65
You are automatically enrolled in Medicare Parts A and B if you have been on Social Security Disability or receiving certain Railroad Retirement Benefits for 24 months.
In Florida, you are also eligible to sign up for any of the 10 available Medicare Supplement plans. Keep in mind, your premium will be different than it would be for someone over 65.
How to Enroll in Medicare Supplement (Medigap) in Florida in 2018
You’ll get the best rate on Medigap policies by signing up during your Open Enrollment Period (OEP). This begins on the first day of the first month you are 65 and signed up for Medicare Part B, and extends for six months.
If you are turning 65, you can arrange to have your Medigap policy and your Part B coverage take effect at the same time.
The advantage of signing up during your OEP is that insurance companies have to issue you a policy. They also can’t charge you extra just because you have a pre-existing condition. This is known as guaranteed issue rights.
In Florida, you also have guaranteed issue rights for two months after termination of employer-sponsored health insurance. If you buy a plan at any other time, you may have a hard time finding coverage. You may have to pay more because of your individual circumstances.
Premiums for Medigap Plans in Florida
Insurance companies charge a premium each month for Medigap plans. These premiums can vary from one insurance company to another, and they also depend on your age, sex and location. If you live in Miami, you may pay a different rate than your cousin in Orlando or Clearwater, even for the same coverage.
Your rate will also depend on the pricing method your insurance company uses. There are three:
- Community rated pricing means everyone pays the same amount, no matter how old they are
- Issue-age-rated pricing means your premium amounts depend on how old you were when your policy was first issued.
- Attained-age-rated pricing means your premium will go up as you get older.
Good news is, Florida is an Issue Age Rated state. Also known as “Entry Age Rated”, this rating method is preferable because your premium will not increase as you age.
United American had a 7.5% rate decrease on their Medigap plans in 2018, that’s not something you see very often. So this might be a carrier you want to inquire about when you contact us.
The Top Florida Medicare Supplement Plans
The top Medicare Supplement Plans in Florida are Plan F, Plan G and Plan N.
- Plan F: This plan is considered the most comprehensive Medigap plan. This is because it has the mostbenefits. It even has a high deductible version that has a lower premium, but still gives you the same benefits.
- Plan G: This plan is the second most popular option. It covers almost all the additional benefit options, and costs a little less than Plan F. The only benefit it doesn’t cover is your Part B deductible, which is $183.
- Plan N: This plan is considered a cost-sharing plan. It requires a small co-payment for some office visits and emergency room visits.
Medicare Advantage Plans in Florida
Florida Medicare Advantage Plans replace your Original Medicare Parts A & B. They cannot be used with Medicare Supplement plans.
Some Medicare beneficiaries enroll in Advantage plans instead of Medigap plans because the premiums are cheaper. However, overtime you’ll end up paying more out of pocket costs.
We find that most beneficiaries in Florida that opted to enroll in Medicare Advantage Plans end up switching back to Original Medicare during the Medicare Advantage Dis-enrollment Period, or MADP.
This is due to the unexpected high out of pocket costs and network limitations Advantage plans come with.
Since Original Medicare and Medigap plans don’t include prescription drug coverage, most Floridians choose to enroll in a Medicare Part D plan.
Florida Prescription Drug Plans work with your Original Medicare and Medicare Supplement plans. Ideally, the perfect Medicare benefits package includes Original Medicare Parts A & B, Medigap and a Medicare Part D Prescription Drug Plans.
To apply for Florida Medicare Supplement, Medicare Advantage or Prescription Drug Plans online, simply complete our rate form. We’ll take your specific information and compare rates with the top carriers in your area.
Our services are 100% free, we’re here to help you understand the Medicare maze. We can also provide information on Dental, Vision and Hearing plans as well as Cancer, Heart Attack & Stroke plans. Contact us today!
Does Medicare pay for assisted living in Florida?
Medicare does not pay for assisted living. However, it does pay for a limited stay in a skilled nursing facility after a hospital stay. The stay must be at least three days.
Does Medicare cover home health care in Florida?
Yes, but you must be under the care of a doctor, be homebound, need speech therapy or skilled nursing care. Also, please note that “home” can be assisted living, a house, an apartment or adult family care housing.
Does Medicare cover dentures in Florida?
Medicare does not cover routine dental care, and therefore it will not pay for dentures. However, you may supplement your Medicare coverage with a standalone dental insurance policy. Keep in mind, some of these policies do provide denture coverage.
Does the Tampa Laser Spine Institute accept Medicare?
Yes, but Medicare only pays for 80% of your medical costs. If you have a Medicare Supplement Plan, a claim will be filled for the remaining 20%. To find out more, go here.
Florida Resources for Medicare
Each state, including Florida, has a Medicare Savings Program to help cover their Medicare costs. There’s also a SHIP center, or in this case SHINE center, that provides counseling to Florida seniors on healthcare benefits. You can also visit the Centers for Medicare and Medicaidservices for more information, or contact us at the number above.
Florida Medicare Facts
The total number of Medicare beneficiaries in Florida in 2015 reached over 4 million. That’s 20% of the entire state population. 14% of eligible beneficiaries were disabled in 2013, over 14,000 were disabled with end-stage renal disease. That same year, over 13,000 Florida residents started receiving benefits from Medicare that were diagnosed with ESRD and had attained the age of 65.